title: Brain flexibility and balance and gait performances mark morphological and metabolic abnormalities in the elderly.
abstract: Although previous studies have found that cerebral white matter hyperintensities are associated with balance-gait disorders, no proton magnetic resonance spectroscopy data at the plane of the basal ganglia have been published. We investigated a possible relationship between balance performance and brain metabolite ratios or structural MRI measurements. We also included neuropsychological tests to determine whether such tests are related to structural or metabolic findings. All 80 participants were taken from the cohort of the Three-City study (Dijon-Bordeaux-Montpellier, France). The ratios of N-acetyl-aspartate to creatine (NAA/Cr) and choline to creatine (Cho/Cr) were calculated in the basal ganglia, thalami and insular cortex. We used univariate regression to identify which variables predicted changes in NAA/Cr and Cho/Cr, and completed the analysis with a multiple linear or logistic regression. After the multivariate analysis including hypertension, age, balance-gait, sex, white matter lesions, brain atrophy and body mass index, only balance-gait performance remained statistically significant for NAA/Cr (p=0.01) and for deep white-matter lesions (p=0.02). The Trail-Making Test is independently associated with brain atrophy and periventricular white-matter hyperintensities. Neuronal and axonal integrity at the plane of the basal ganglia is associated with balance and gait in the elderly, whereas brain flexibility is associated with structural MRI brain abnormalities.
authors.affiliation: Neuroradiology, Dijon University Hospital, Dijon Cedex, France. douraied.bensalem@chu-dijon.fr
authors.forename: Douraied
authors.initials: D
authors.lastname: Ben Salem
authors.forename: Paul M
authors.initials: PM
authors.lastname: Walker
authors.forename: Serge
authors.initials: S
authors.lastname: Aho
authors.forename: Béatrice
authors.initials: B
authors.lastname: Tavernier
authors.forename: Maurice
authors.initials: M
authors.lastname: Giroud
authors.forename: Christophe
authors.initials: C
authors.lastname: Tzourio
authors.forename: Frédéric
authors.initials: F
authors.lastname: Ricolfi
authors.forename: François
authors.initials: F
authors.lastname: Brunotte
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000378:metabolism / Q000473:pathology / Q000502:physiology; D001224:Aspartic Acid / Q000378:metabolism; D001921:Brain / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D002794:Choline / Q000378:metabolism; D018672:Community Health Planning; D003401:Creatine / Q000378:metabolism; D005260:Female; D005684:Gait / Q000502:physiology*; D005853:Geriatrics; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D008659:Metabolic Diseases / Q000209:etiology* / Q000473:pathology*; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D004856:Postural Balance / Q000502:physiology*
chemical_list: D001224:Aspartic Acid; D003401:Creatine; D002794:Choline